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� PERMIT APPLICATION <br /> BUILDING 1 MECHANICAL! PLUMBf NG /SIGN /SPRINKLER/ DEMQLITION <br /> CI7Y OF EVERETT PERMIT SERVECES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8E�10 � FAX 425-257-8857 i (E)everetteps@everettwa.gov� www.everethva.gov/permits <br /> {Btue'or:Black Ink'Only Please) PROJECT SITE:INFORMATION <br /> PROJECT S[TE ADDRESS: ,/ i ` ,�1 r, PROPERTY TAX#: 1(�;���� �lC;�t� <br /> LEGAL for new construction: Short PlaUsubdivision_ � Lot No. (attach copy of long lega[description) <br /> CONTAGT 1NFORMATION <br /> OWNER NAME: ` �,b u '������ `� �� TENANT NAME(lf Commercial): <br /> OWNER MAILING ADDRESS: STRSET ' �„ �T �j'r' <br /> C1TY ���f STA—E - ZIP � � .. 'd <br /> OWNER PHONE: � `'- 7' ' OWNER EMAiL: � <br /> CONTRACTOR NAM6; G&S HEATING <br /> CONTRACTOR ADDRESS' sTREeT 3409 EVERETT AVE <br /> ciTy EVERETT srAre WA zip 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@gSF1EATING.COM <br /> CONTRACTOf2 LICENSE#(REQUIRED): GSHEAC"939RK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O"19655 <br /> PR(MARY CONTACT: ❑OWNER C�CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: DAUVN WEIMER CONTACT PHONE: 425-252-4402 <br /> CON7ACT EMAIL: DAWN@GSHEATING.COM <br /> BUILDING PERMIT APPLICATION <br /> RESIDENTIAL �� <br /> Existin Use of Buildin : Corttract Price of Work:$ � IC� <br /> Proposed Use of Building: RESIDEN7IAL Heat Source: ❑Gas Electric ❑O:her <br /> Buildin T pe; C�SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famify�ofUnits: ❑Commerciai �Industriai <br /> 7ype of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> ��reS��_ -C�'�,-�"(,�.`r1� <br /> AS50CIATED BUILDING PERMI7#(if apolicable : <br /> MECHANICAL PERMIT AP ICA710N PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Altere�_Repair Type of Project: �New Addn _Alteretion �Repair <br /> #of LisL of Fixtures #of Lisi of Fixfures #�f List of Fixtures #of Lisi of Fixtures <br /> Fixfures Fixfures Fixfu�es FiXtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(IRside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin} Drinking Fountain <br /> Wa#er Heater Ref�igeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.; Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT:;have revrewed this applrcafion and confrrm the information contained herein rs frue arrd correct.Work done pursuant to this permif must�omply wifh <br /> cunent federal,sfafe,and loca!/aw. The granfing of a pemnit only authorizes approved work artd no devietions therefrom.Deviations must frrsf be auEhonzed in writing`rom the <br /> Building O�cia!before beinq authonzed under any circumstance.1 am fhe owner,or!am autho�ized by the ov✓ner of fhis property to pe�form fhe work for which application is made, <br /> and I comply with the State Contracfors Lew 18.27 RCW and 296.200A WAC. <br /> Cify of Everett Offcia!Use Oniy <br /> PER I� . � r a y� <br /> '�_._---_ � +-Y �i�i <br /> Owner/Authorized Agent Signature ate (Revised 9/23/20 6) <br /> _____ . __ _._ __ _ _ _ __._.._ __ <br />